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World J Gastroenterol. Feb 14, 2007; 13(6): 930-933
Published online Feb 14, 2007. doi: 10.3748/wjg.v13.i6.930
Omeprazole-based triple therapy with low-versus high-dose of clarithromycin plus amoxicillin for H pylori eradication in Iranian population
Ali Asghar Keshavarz, Homayoon Bashiri, Mahtab Rahbar
Ali Asghar Keshavarz, Department of Gastroenterology and Hepatology, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
Homayoon Bashiri, Department of Internal Medicine Emam Reza Hospital, Kermanshah, Iran
Mahtab Rahbar, Department of Pathology, Emam Reza Hospital, Kermanshah, Iran
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Ali Asghar Keshavarz, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran. dr_keshavarz@yahoo.com
Telephone: +98-831-7244800 Fax: +98-831-7244700
Received: October 26, 2006
Revised: November 13, 2006
Accepted: January 5, 2007
Published online: February 14, 2007
Abstract

AIM: To investigate the efficacy and tolerability of H pylori eradication in an omeprazole-based triple therapy with high- and low-dose of clarithromycin and amoxicillin.

METHODS: One hundred and sixty H pylori positive patients were randomly assigned to two groups based on the following 2 wk investigation; (1) group A or low-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 250 mg b.i.d and amoxicillin 500 mg b.i.d; and (2) group B or high-dose regimen received omeprazole 20 mg b.i.d, clarithromycin 500 mg b.i.d and amoxicillin 1000 mg b.i.d. During the study H pylori status was assessed by histology and rapid urease test prior and by 13C-urea breath test 6 wk after the therapy. Standard questionnaires were administered to determine the compliance to treatment and possible adverse events of therapy. Data were subject to χ2 to compare the eradication rates in the two groups. The significant level of 95% (P≤ 0.05) was considered statistically different.

RESULTS: We found that the per-protocol eradication rate was 88% (68/77) in group A, and 89% (67/75) in group B. The intension-to-treat eradication rate was 85% (68/80) in group A and 83.75% (67/80) in group B. Overall adverse events were 26% in group A and 31% in group B. The adverse events were generally mild in nature and tolerated well in both groups with a compliance of 98% in group A vs 96% in group B.

CONCLUSION: The omeprazole-based low dose regimen of clarithromycin and amoxicillin for two weeks in H pylori eradication is as effective as high dose regimen in Iranian population.

Keywords: Triple therapy; H pylori; Amoxicillin; Clarithromycin; Low-dose regimen